Intervention in a village

[Guest guest]

Dear Umesh,

This is in response to your posting requesting information on village level

intervention for HIV prevention.

The description " having low literacy level, low socio-economic status and

totally male dominated " will fit more than 80% of the Indian villages. So

we could say the strategies adopted in any of the villages could be

applicable in your case also.

But I must say you must start with " men as high-risk group " , address them

exclusively. Usually all health projects address women, as they are sitting

ducks at home. But forgets about the power relation in sexual matters. So

if you start with women, all you will end up is the creation of fear also

along with their powerless existence now. They may be easy to approach and

available. But make sure, how difficult it may seem, that you address the

men first.

Again never talk to men in the language of fear and death. For they always

live dangerously in life situations and at work. But approach them with the

idea of pleasure and then health. Tell them we need health to sustain

pleasure. You may encounter resistance among them in using safe sex methods

especially condom. Tell them there are ways to wear condom pleasurably,

say, asking your partner to put them on. Slowly build the idea of health

woven strongly with the idea of pleasure. Or else they may listen stoically

but will never practice.

Next workout the ways to bring the topic to injustice in power relations

exist in gender relations. How actually a submissive and docile wife lessen

the pleasure principle and also stress the aspect of an active partner

heightens pleasure. Also mention that is why men seek out sex workers. Thus

once you can build around pleasure all health aspects, then men will

listen. More over in existing conditions it is men who takes initiative in

all sexual matters.

In short make men first responsible to their acts.

Once this part is initiated then you can ask the village heads to address

the issue of HIV/AIDS broadly. Awareness campaigns and meetings.

Only after this, you must address women exclusively and show the

disparities in gender relations and that they should ask their spouses to

use safe sex methods. This way the men won't feel affronted when women dare

to ask them. This way you can avoid lot of violence and bitterness among

couples.

Don't stick to ' condoms as the only method' to safe sex practice. Make

sure you teach them the pleasures of mutual masturbation, using thighs etc.

etc. Tell to avoid penetrative sex as far as possible and if need be then

only use condoms. Tell men that penetrative sex is for making babies and

that they don't have to push their stick in all the encounters.

Now, we have to show that there are different sexuality groups and there is

nothing to hide or shameful about it. That sex between consenting adults -

between man and man, woman and woman, man and intersex person, woman and

intersex person or among intersex persons - is permissible and 'quite

natural' also. And also there are bisexual persons and there are different

shades of sexual orientation. And also there are confused persons with

their different sexual orientations, but all is okay, if it is done on

mutual agreement with respect and concern. Again show them that there are

different sexual practices and all are acceptable with above agreement.

What is wrong in sexual encounters is what is forced and without consent.

Tell men, even if it happens between married couples, it is wrong.

In short teach sexuality in depth to bring about behavioral changes. Only

in a brothel set up one can demand the use of condom in sexual encounters.

All other relationships need mutual agreement, responsibility, respect and

concern, in short, love.

Now, when it comes to IEC, stick to the usual literature. Men will ask

about sexual matters, about pleasure and other details. Talk about these in

small, comfortable groups. Never write a literature to explain it, for

there will be 'moral morons' around who will topple the apple cart. The

fundamentalist business will come into action, so don't leave anything for

them to chew upon. Any confrontation - deny everything, but if you leave

anything written, you will be in trouble. Police and fundamentalist mafia

will make mince meat of you; have a case study of the NAZ foundation

people. Sex and politics of power goes together.

Make sure that condoms are available once you promote it. Easy availability

enhances the use.

The most neglected part is the treatment given to the AIDS patients. You

have to fight for the medicines with all the authorities. This you should

do with other NGOs in all levels.

Now, we have to address the stigma around PLWHAs. Make people sensitive

about it. If possible include in your team an HIV+ person. If there are

already HIV+ people in the village, this will help immensely. Moreover this

will wipe out fear and discrimination immediately. People see what is

preached as practised.

Start a care centre, if there are any AIDS patients but to treat them you

need expert people.

Okay these are some of the thoughts that crossed my mind. If you ask on

specific matters I may be able to answer them later. Say, I may not know

all the answers but all I am saying I am ready.

Love

Maitreya

E-mail: <maitreya@...>

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